The First Association of a Primary Amebic Meningoencephalitis Death With Culturable Naegleria fowleri in Tap Water From a US Treated Public Drinking Water System

被引：90

作者：

Cope, Jennifer R. ^{[1
]}

Ratard, Raoult C. ^{[2
,3
]}

Hill, Vincent R. ^{[1
]}

Sokol, Theresa ^{[2
,3
]}

Causey, Jonathan Jake ^{[2
,3
]}

Yoder, Jonathan S. ^{[1
]}

Mirani, Gayatri ^{[4
]}

Mull, Bonnie ^{[1
]}

Mukerjee, Kimberly A. ^{[4
]}

Narayanan, Jothikumar ^{[1
]}

Doucet, Meggie ^{[4
]}

Qvarnstrom, Yvonne ^{[1
]}

Poole, Charla N. ^{[4
]}

Akingbola, Olugbenga A. ^{[4
]}

Ritter, Jana M. ^{[1
]}

Xiong, Zhenggang ^{[4
]}

da Silva, Alexandre J. ^{[1
]}

Roellig, Dawn ^{[1
]}

van Dyke, Russell B. ^{[4
]}

Stern, Harlan ^{[4
]}

Xiao, Lihua ^{[1
]}

Beach, Michael J. ^{[1
]}

机构：

[1] Ctr Dis Control & Prevent, Atlanta, GA USA

[2] Louisiana Dept Hlth & Hosp, New Orleans, LA USA

[3] Louisiana Dept Hlth & Hosp, Baton Rouge, LA 70821 USA

[4] Tulane Univ, Hlth Sci Ctr, New Orleans, LA 70118 USA

来源：

CLINICAL INFECTIOUS DISEASES | 2015年 / 60卷 / 08期

关键词：

Naegleria fowleri; primary amebic meningoencephalitis; free-living ameba; BALAMUTHIA-MANDRILLARIS; ACANTHAMOEBA SPP; PCR;

D O I：

10.1093/cid/civ017

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. Naegleria fowleri is a climate-sensitive, thermophilic ameba found in warm, freshwater lakes and rivers. Primary amebic meningoencephalitis (PAM), which is almost universally fatal, occurs when N. fowleri-containing water enters the nose, typically during swimming, and migrates to the brain via the olfactory nerve. In August 2013, a 4-year-old boy died of meningoencephalitis of unknown etiology in a Louisiana hospital. Methods. Clinical and environmental testing and a case investigation were initiated to determine the cause of death and to identify potential exposures. Results. Based on testing of cerebrospinal fluid and brain specimens, the child was diagnosed with PAM. His only reported water exposure was tap water; in particular, tap water that was used to supply water to a lawn water slide on which the child had played extensively prior to becoming ill. Water samples were collected from both the home and the water distribution system that supplied the home and tested; N. fowleri was identified in water samples from both the home and the water distribution system. Conclusions. This case is the first reported PAM death associated with culturable N. fowleri in tap water from a US treated drinking water system. This case occurred in the context of an expanding geographic range for PAM beyond southern states, with recent case reports from Minnesota, Kansas, and Indiana. This case also highlights the role of adequate disinfection throughout drinking water distribution systems and the importance of maintaining vigilance when operating drinking water systems using source waters with elevated temperatures.

引用

页码：E36 / E42

页数：7

共 18 条

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